Tolerance intervals are used to statistically derive the acceptance limits to which drugs must conform upon manufacture (release) and throughout shelf-life. The single measurement per lot in release data and repeated measurements per lot longitudinally for stability data have to be considered in the calculation. Methods for the one-way random effects model by Hoffman and Kringle (HK) for two-sided intervals and Hoffman (H) for one-sided limits are extended to a random-intercept, fixed-slope model in this paper. The performance of HK and H was evaluated via simulation by varying the following factors: (a) magnitude of stability trend over time, (b) sample size, (c) percentage of lot-to-lot contribution to total variation, (d) targeted proportion, and (e) data inclusion. The performance metrics are average width (for two-sided) or average limit (for one-sided) and attained confidence level. HK and H maintained nominal confidence levels as originally developed, but H is too conservative (i.e., achieved confidence level exceeds the nominal level) in some situations. The HK method adapted for an attribute that changes over time performed comparably to the more computationally intensive generalized pivotal quantity and Bayesian posterior predictive methods. Mathematical formulas and example calculations as implemented using R statistical software functions are provided to assist practitioners in implementing the methods. The calculations for the proposed approach can also be easily performed in a spreadsheet given basic regression output from a statistical software package. Microsoft Excel spreadsheets are available from the authors upon request. Tolerance intervals (a measure of what can be expected from the manufacturing process) calculated from attribute measurements of drug product lots are one of the factors considered when establishing acceptance limits to ensure drug product quality. The methods often used to calculate tolerance intervals when there are multiple measurements per lot and the attribute changes over time are either lacking in statistical rigor or statistically rigorous but computationally intensive to implement. The latter type requires simulations that have to be programmed using specialized statistical software, because closed-form mathematical formulas are not available. As a consequence, some quality practitioners and applied statisticians involved in setting acceptance limits may be hindered in using such computationally intensive methods. This paper aims to address this need by proposing an approach that is statistically rigorous yet simple enough to implement using spreadsheets. The approach builds upon previously published works developed for attributes that do not change over time and adapts the cited works for attributes that change over time. The proposed approach is demonstrated to have good statistical properties and compares favorably against the more computationally intensive alternative methods. The paper provides closed-form mathematical formulas, example data, and illustrative calculations as implemented in programmed R functions to facilitate implementation by practitioners. Alternatively, the calculations can be performed without requiring complex programming/simulation using Microsoft Excel spreadsheets that can be requested from the authors.
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http://dx.doi.org/10.5731/pdajpst.2018.008839 | DOI Listing |
Comput Biol Med
January 2025
Department of Pharmacy and Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, Republic of Korea; Department of Pharmaceutical Medicine and Regulatory Science, Yonsei University, Incheon, Republic of Korea; Graduate Program of Industrial Pharmaceutical Science, Yonsei University, Incheon, Republic of Korea; Department of Integrative Biotechnology, Yonsei University, Incheon, Republic of Korea. Electronic address:
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Department of Internal Medicine, Division of Cardiology, Kangdong Sacred Heart Hospital, Seoul 05355, Republic of Korea.
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Anaesthesiology and Pain Department, Institut de Cancérologie de l'Ouest, 49055 Angers, France.
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Department of Medicine, The Masonic Cancer Center, The University of Minnesota Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
Desmoid-type fibromatosis (DTF) is a locally invasive tumor composed of myofibroblast-like cells and collagen; it does not metastasize but can cause significant local morbidity. Most sporadic cases are associated with mutations in the CTNNB1 gene, which encodes beta-catenin. Various treatments have been used with differing efficacy and toxicity profiles.
View Article and Find Full Text PDFHealthcare (Basel)
January 2025
Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Grattan St., Melbourne, VIC 3010, Australia.
Background/objectives: Early-onset sepsis in neonates is a potentially catastrophic condition that demands prompt management. However, laboratory diagnosis via cerebral spinal fluid and blood tests is often inconclusive, so diagnosis on the basis of clinical symptoms and risk factors is frequently required, and the majority of neonates treated with antibiotics for presumed early-onset sepsis (PEOS) do not have culture-proven sepsis. The management of such PEOS is mainly achieved via antibiotic therapy, which itself has adverse effects, creating a dilemma for clinicians in optimising healthcare.
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